Adaptation and Implementation of a Volunteer-Delivered, Telephone-Based, Social Support Program HOW-R-U? During the COVID-19 Pandemic: A Pragmatic Study

Background and objectives: Public health concerns surrounding social isolation and loneliness heightened during the coronavirus disease 2019 (COVID-19) pandemic, as infection prevention measures led to increased feelings of loneliness and depression. Our objective was to evaluate the implementation of the HOW-R-U? program, during the pandemic (March 2020-December 2021). HOW-R-U? is a weekly volunteer-delivered telephone program designed to facilitate social connection and ease feelings of social isolation, loneliness, and depression in older people.

Research design and methods: This pragmatic study used the Implementation Framework for Aged Care to adapt and implement HOW-R-U? in an Australian aged and community care organization and a tertiary health service in Melbourne. The evaluation involved analysis of program data, semistructured interviews, and surveys with program recipients, volunteers, and referrers. A process evaluation was conducted alongside an assessment of outcomes including pre- and post-symptoms of isolation, depression, and loneliness.

Results: The implementation evaluation indicated that codesigned systems and processes effectively supported the ongoing implementation of HOW-R-U? with transition into business as usual across both organizations. Recipients reported that telephone calls had a positive impact on their lives, whereas volunteers reported enjoyment of supporting others. Several challenges were identified, namely in program reach and fidelity.

Discussion and implications: HOW-R-U? was well regarded by all involved, and evaluation learnings have informed implementation into business as usual by both organizations.